We live in a health data world of increasing and accelerating complexity. Rapid advancements in technology create consumers who expect and get real-time services. Regulations have imposed aggressive and costly compliance deadlines, some of which have passed. Core enterprise systems like EMRs, ERP, Claims, and Care Management (among others) require upgrading and, in some cases, must continually evolve to meet ever more complex federal certification standards. Putting aside mandates, healthcare must evolve to realize the benefits that process automation, data exchange, AI, and other health IT modernization will bring to health equity, patient experience, and administrative burden reduction.
This increasing and accelerating complexity can be exhausting. It disrupts the organization’s commitment to its core and enduring missions of good and just care, financial stewardship, and community leadership. It requires changes to workflows that often have been in place for a long time and that, while not perfect, everyone understands and is used to following. Best practices evolve faster than they can be implemented. This complexity affects not just the technology or data professionals on the front lines of health IT but entire organizations. It requires dissolving many of the data and process silos in place today. It demands more communication and cooperation across organizations, business units, roles, and locations. Doing this might require a culture shift in some organizations, which can prove difficult and painful.
This is where MHDC Consulting can help. We have the experience, knowledge, and expertise to assist members of our community in working with and through these changes to get to a better future. MHDC Consulting can help to make this process more tolerable, understandable, and efficient.
MHDC Consulting assists organizations with education on and evaluation of the processes and workflows that make health data and data exchange work, in health IT prototyping and pilot projects, in specification and project design, and in evaluation and analysis of business processes and healthcare workflows on a larger scale.
With support from a Mass eHealth Collaborative grant, NEHEN is helping to prototype prior authorization automation, sometimes called electronic prior authorization or ePA. The experience gained from working with Blue Cross Blue Shield of Massachusetts (BCBSMA), Olive, and the New England Baptist Hospital on an actual implementation is invaluable in assisting those who want to understand what successful automation requires.
MHDC is facilitating a series of health equity training sessions for BCBSMA, helping their provider networks better understand the role of modern data and data exchange standards in equity projects and some of the organizational changes needed to support them.
With funding from the Health Policy Commission and four healthcare technology services companies, our partnership with the Network for Excellence in Health Innovation has convened healthcare stakeholders to endorse prior authorization automation statewide in two years. We anticipate successfully assisting providers, physicians, and payers in reaching this milestone and hope to continue to advance healthcare policy at the state and federal levels.
Our goals are to work on a variety of consulting projects that improve healthcare by making modern advancements in data and health IT more accessible, more standardized, easier to use, easier to implement, and easier to justify investments in and to leverage all of this to achieve a more equitable, more patient-centric healthcare ecosystem.
Apr 13, 9am (Free for members*; Open to public with fee to register) MHDC Executive Forum Series: The Road to Interoperability -Foundations: Data Standards
*Not a member? Learn about our organizational memberships HERE.
Missed an event? Click HERE for on-demand recordings!
Updates
We completed our detailed discussions on the CMS Advancing Interoperability and Improving Prior Authorization Processes NPRM and submitted a comment, available HERE. We also finalized and submitted comments on the OMB Initial Proposals for Updating Race and Ethnicity Statistical Standards (available on the same page linked above).
On the ePA front, we continue to work with the Network for Excellence in Healthcare Innovation (NEHI) and the Health Policy Commission (HPC) on a statewide plan for adopting fully automated electronic prior authorization by 1/1/2026, using the three DaVinci implementation guides (IGs) covering the prior authorization process.
We have recently received and uploaded a Casemix data update from CHIA that contains missing data from the FY21 dataset including encounters from Sturdy Memorial Hospital.
Did you know you can create a report in Spotlight using specific Z-codes (ICD-10-CM socioeconomic diagnosis codes) to help you get a better understanding of SDOH or health equity volume/encounters for your hospital or others?
We all work in companies in the healthcare sector and most of us routinely receive HIPAA training whether or not we're in clinical settings. This training should make us very aware of what is considered PHI. No MHDC employees work in clinical settings, but we all get this training.
Sometimes, when we're in our role as patients, we have cause to wonder if the staff at hospitals or clinics have had the same training. It's very common to have shared spaces in these settings, especially in pre-surgical, recovery, and ED settings.
The regulatory timeline chart has a new home. Click HERE
Industry Events
Interested in what's happening with health data, health IT, health equity, patient engagement, regulatory impact, etc.? Check out these upcoming online events:
